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双源64层CT与经胸超声心动图在诊断复杂先天性心脏病中的对照研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2012年第3期
页码:
391-394
栏目:
临床研究
出版日期:
2012-06-25

文章信息/Info

Title:
Control study of dual-source computed tomography and ultrasound cardiography in diagnosis of complex congenital heart diseases
作者:
王晓武; 张 本; 袁彬彬; 张卫达; 梅鲁刚
(广州军区广州总医院心血管外科中心，广东 广州 510010)
Author(s):
WANG Xiao-wu;  ZHANG Ben;  YUAN Bin-bin;  ZHANG Wei-da;  MEI Lu-gang
(Centre of Cardiovascular Surgery, Guangzhou General Hospital, Guangzhou Military Area Command, Guangzhou 510010, Guangdong, China)
关键词:
心脏病; 先天性; 复杂; 双源计算机断层成像; 超声心动图; 对照研究
Keywords:
complex congenital heart disease;  dual-source computed tomography;  ultrasound cardiography;  contrast/control study
分类号:
R654.2
DOI:
-
文献标识码:
A
摘要:
目的:探讨双源64层CT（DSCT）在诊断复杂先天性心脏病(CCHD)中的应用价值，并与经胸超声心动图（TTE）进行对照研究。方法： 对186例CCHD患者同期行DSCT和TTE检查，以手术结果为标准，在心内异常解剖、心外大血管畸形的诊断上进行回顾性分析。结果： 手术证实心血管畸形共538处。DSCT检出506处，检出率为94.1%，TTE检出497处，检出率 为92.4%，两者差异无统计学意义，但两者联合检查检出529处，检出率达98.3%，明显高于单项检查（P<0.01）。其中，①心脏部分畸形：共 209处，DSCT检出190处，检出率为90.9%，TTE检出200处，检出率为 95.7%，两者差异无统计学意义；②心脏-大血管连接部分异常：共103 处，DSCT检出94 处，检出率为91.3%，TTE检出91处，检出率为88.4%，两者差异无统计学意义；③大血管部分畸形：共226处，DSCT检出222处，检出率为98.2%，TTE检出 206处，检出率为91.1%，两者差异有统计学意义（P<0.01），DSCT检出率显著高于TTE。结论： ①DSCT诊断心外大血管畸形的检出率高于TTE，对可疑并发大血管畸形的复杂先天性心脏病应作为常规检查手段；②DSCT与TTE联合应用可提高CCHD术前诊断的检出率。
Abstract:
AIM:To evaluate the clinical value of dual-source computed tomography (DSCT) in diagnosis of complex congenital heart diseases (CCHD) using a control study with transthoracic ultrasound cardiography (UCG). METHODS: DSCT and UCG were performed in 186 patients with CCHD and their diagnosis of cardiovascular anomalies was later surgically confirmed and compared. RESULTS: In all patients, 538 cardiovascular anomalies were confirmed. Accuracy of DSCT and UCG was 94.1% and 92.4%, respectively, and diagnostic accuracy showed no statistical difference (P=0.281). Of the 209 confirmed intracardiac anomalies, DSCT detected 190 (90.9%) and UCG detected 200 (95.7%), with no statistical difference in the diagnostic accuracy rate (P=0.052). Of the 103 confirmed heart-vessel conjunction anomalies, DSCT detected 94 (91.3%) and UCG detected 91 (88.4%), also with no statistical difference in the diagnostic accuracy rate (P=0.629). Of the 226 confirmed great vessel anomalies, statistical difference was observed in the diagnostic accuracy between the 222 (98.2%) detected by DSCT and the 206(91.1%) detected by UCG (P<0.01), showing that DSCT was superior to UCG. CONCLUSION: DSCT is superior to transthoracic UCG in the diagnosis of great vessel anomalies and can be used as one of the non-invasive conventional preoperative detection methods for CCHD. Use of DSCT combined with UCG can improve the diagnostic accuracy of CCHD.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2011-11-27.基金项目：广东省科技计划项目资助(2010A040300001) 作者简介：王晓武，主任医师，博士 Email:xzwk_wxw@hotmail.com
更新日期/Last Update: 2012-05-02